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Vallinoja J, Nurmi T, Jaatela J, Wens V, Bourguignon M, Mäenpää H, Piitulainen H. Functional connectivity of sensorimotor network is enhanced in spastic diplegic cerebral palsy: A multimodal study using fMRI and MEG. Clin Neurophysiol 2024; 157:4-14. [PMID: 38006621 DOI: 10.1016/j.clinph.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/02/2023] [Accepted: 10/15/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE To assess the effects to functional connectivity (FC) caused by lesions related to spastic diplegic cerebral palsy (CP) in children and adolescents using multiple imaging modalities. METHODS We used resting state magnetoencephalography (MEG) envelope signals in alpha, beta and gamma ranges and resting state functional magnetic resonance imaging (fMRI) signals to quantify FC between selected sensorimotor regions of interest (ROIs) in 11 adolescents with spastic diplegic cerebral palsy and 24 typically developing controls. Motor performance of the hands was quantified with gross motor, fine motor and kinesthesia tests. RESULTS In fMRI, participants with CP showed enhanced FC within posterior parietal regions; in MEG, they showed enhanced interhemispheric FC between sensorimotor regions and posterior parietal regions both in alpha and lower beta bands. There was a correlation between the kinesthesia score and fronto-parietal connectivity in the control population. CONCLUSIONS CP is associated with enhanced FC in sensorimotor network. This difference is not correlated with hand coordination performance. The effect of the lesion is likely not fully captured by temporal correlation of ROI signals. SIGNIFICANCE Brain lesions can show as increased temporal correlation of activity between remote brain areas. We suggest this effect is likely separate from typical physiological correlates of functional connectivity.
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Affiliation(s)
- Jaakko Vallinoja
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. BOX 12200, 00076 AALTO Espoo, Finland.
| | - Timo Nurmi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. BOX 12200, 00076 AALTO Espoo, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. BOX 35, FI-40014 Jyväskylä, Finland
| | - Julia Jaatela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. BOX 12200, 00076 AALTO Espoo, Finland
| | - Vincent Wens
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles (LN(2)T), UNI - ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium; Department of Translational Neuroimaging, HUB - Hôpital Erasme, Brussels, Belgium
| | - Mathieu Bourguignon
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles (LN(2)T), UNI - ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Neurophysiology and Movement Biomechanics, UNI - ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium; BCBL, Basque Center on Cognition, Brain and Language, 20009 San Sebastian, Spain
| | - Helena Mäenpää
- Department of Child Neurology, New Children's Hospital, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
| | - Harri Piitulainen
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O. BOX 12200, 00076 AALTO Espoo, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. BOX 35, FI-40014 Jyväskylä, Finland; Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland
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Illman M, Jaatela J, Vallinoja J, Nurmi T, Mäenpää H, Piitulainen H. Altered excitation-inhibition balance in the primary sensorimotor cortex to proprioceptive hand stimulation in cerebral palsy. Clin Neurophysiol 2024; 157:25-36. [PMID: 38039924 DOI: 10.1016/j.clinph.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 10/13/2023] [Accepted: 10/27/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE Our objective was to clarify the primary sensorimotor (SM1) cortex excitatory and inhibitory alterations in hemiplegic (HP) and diplegic (DP) cerebral palsy (CP) by quantifying SM1 cortex beta power suppression and rebound with magnetoencephalography (MEG). METHODS MEG was recorded from 16 HP and 12 DP adolescents, and their 32 healthy controls during proprioceptive stimulation of the index fingers evoked by a movement actuator. The related beta power changes were computed with Temporal Spectral Evolution (TSE). Peak strengths of beta suppression and rebound were determined from representative channels over the SM1 cortex. RESULTS Beta suppression was stronger contralateral to the stimulus and rebound was weaker ipsilateral to the stimulation in DP compared to controls. Beta modulation strengths did not differ significantly between HP and the control group. CONCLUSIONS The emphasized beta suppression in DP suggests less efficient proprioceptive processing in the SM1 contralateral to the stimulation. Their weak rebound further indicates reduced intra- and/or interhemispheric cortical inhibition, which is a potential neuronal mechanism for their bilateral motor impairments. SIGNIFICANCE The excitation-inhibition balance of the SM1 cortex related to proprioception is impaired in diplegic CP. Therefore, the cortical and behavioral proprioceptive deficits should be better diagnosed and considered to better target individualized effective rehabilitation in CP.
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Affiliation(s)
- Mia Illman
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O.BOX 35, FI-40014 Jyväskylä, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O.BOX 12200, FI-00760 AALTO, Espoo, Finland; Aalto NeuroImaging, Aalto University School of Science, P.O.BOX 12200, FI-00760 AALTO, Espoo, Finland.
| | - Julia Jaatela
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O.BOX 12200, FI-00760 AALTO, Espoo, Finland
| | - Jaakko Vallinoja
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O.BOX 12200, FI-00760 AALTO, Espoo, Finland
| | - Timo Nurmi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O.BOX 12200, FI-00760 AALTO, Espoo, Finland
| | - Helena Mäenpää
- Pediatric Neurology, New Children's Hospital, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
| | - Harri Piitulainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O.BOX 35, FI-40014 Jyväskylä, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, P.O.BOX 12200, FI-00760 AALTO, Espoo, Finland; Pediatric Neurology, New Children's Hospital, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, Finland
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Trevarrow MP, Bergwell HE, Groff BR, Wiesman AI, Wilson TW, Kurz MJ. Youth with Cerebral Palsy Display Abnormal Somatosensory Cortical Activity During a Haptic Exploration Task. Neuroscience 2023; 515:53-61. [PMID: 36796750 PMCID: PMC10023489 DOI: 10.1016/j.neuroscience.2023.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 01/22/2023] [Accepted: 01/25/2023] [Indexed: 02/16/2023]
Abstract
There are numerous clinical reports that youth with cerebral palsy (CP) have proprioceptive, stereognosis and tactile discrimination deficits. The growing consensus is that the altered perceptions in this population are attributable to aberrant somatosensory cortical activity seen during stimulus processing. It has been inferred from these results that youth with CP likely do not adequately process ongoing sensory feedback during motor performance. However, this conjecture has not been tested. Herein, we address this knowledge gap using magnetoencephalographic (MEG) brain imaging by applying electrical stimulation to the median nerve of youth with CP (N = 15, Age = 15.8 ± 0.83 yrs, Males = 12, MACS levels I-III) and neurotypical (NT) controls (N = 18, Age = 14.1 ± 2.4 yrs, Males = 9) while at rest (i.e., passive) and during a haptic exploration task. The results illustrated that the somatosensory cortical activity was reduced in the group with CP compared to controls during the passive and haptic conditions. Furthermore, the strength of the somatosensory cortical responses during the passive condition were positively associated with the strength of somatosensory cortical responses during the haptic condition (r = 0.75, P = 0.004). This indicates that the aberrant somatosensory cortical responses seen in youth with CP during rest are a good predictor of the extent of somatosensory cortical dysfunction during the performance of motor actions. These data provide novel evidence that aberrations in somatosensory cortical function in youth with CP likely contribute to the difficulties in sensorimotor integration and the ability to effectively plan and execute motor actions.
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Affiliation(s)
- Michael P Trevarrow
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
| | - Hannah E Bergwell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
| | - Boman R Groff
- Department of Psychology & Neuroscience, University of Colorado, Boulder, CO, USA
| | | | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA; Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
| | - Max J Kurz
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA; Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA.
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Trevarrow M, Sanmann JN, Wilson TW, Kurz MJ. A Val 66Met polymorphism is associated with weaker somatosensory cortical activity in individuals with cerebral palsy. Heliyon 2022; 8:e10545. [PMID: 36119851 PMCID: PMC9474307 DOI: 10.1016/j.heliyon.2022.e10545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 06/21/2022] [Accepted: 08/31/2022] [Indexed: 11/27/2022] Open
Abstract
Background The brain-derived neurotrophic factor (BDNF) protein plays a prominent role in the capacity for neuroplastic change. However, a single nucleotide polymorphism at codon 66 of the BDNF gene results in significant reductions in neuroplastic change. Potentially, this polymorphism also contributes to the weaker somatosensory cortical activity that has been extensively reported in the neuroimaging literature on cerebral palsy (CP). Aims The primary objective of this study was to use magnetoencephalography (MEG) to probe if BDNF genotype affects the strength of the somatosensory-evoked cortical activity seen within individuals with CP. Methods and procedures and Procedures: Twenty individuals with CP and eighteen neurotypical controls participated. Standardized low resolution brain electromagnetic tomography (sLORETA) was used to image the somatosensory cortical activity evoked by stimulation of the tibial nerve. BDNF genotypes were determined from saliva samples. Outcomes and results The somatosensory cortical activity was weaker in individuals with CP compared to healthy controls (P = 0.04). The individuals with a Val66Met or Met66Met BDNF polymorphism also showed a reduced response compared to the individuals without the polymorphism (P = 0.03), had higher GMFCS levels (P = 0.04), and decreased walking velocity (P = 0.05). Conclusions and implications These results convey that BDNF genotype influences the strength of the somatosensory activity and mobility in individuals with CP. What this paper adds Previous literature has extensively documented altered sensorimotor cortical activity in individuals with CP, which ultimately contributes to the clinical deficits in sensorimotor processing documented in this population. While some individuals with CP see vast improvements in their sensorimotor functioning following therapeutic intervention, others are clear non-responders. The underlying basis for this discrepancy is not well understood. Our study is the first to identify that a polymorphism at the gene that codes for brain derived neurotrophic factor (BDNF), a protein well-known to be involved in the capacity for neuroplastic change, may influence the altered sensorimotor cortical activity within this population. Potentially, individuals with CP that have a polymorphism at the BDNF gene may reflect those that have difficulties in achieving beneficial outcomes following intervention. Thus, these individuals may require different therapeutic approaches in order to stimulate neuroplastic change and get similar benefits from therapy as their neurotypical peers.
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Affiliation(s)
- Michael Trevarrow
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
| | - Jennifer N Sanmann
- Department of Genetic Medicine, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA.,Department of Pharmacology and Neuroscience, College of Medicine, Creighton University, Omaha, NE, USA
| | - Max J Kurz
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA.,Department of Pharmacology and Neuroscience, College of Medicine, Creighton University, Omaha, NE, USA
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Bergwell H, Trevarrow M, Corr B, Baker S, Reelfs H, Wilson TW, Moreau NG, Kurz MJ. Power training alters somatosensory cortical activity of youth with cerebral palsy. Ann Clin Transl Neurol 2022; 9:659-668. [PMID: 35297546 PMCID: PMC9082383 DOI: 10.1002/acn3.51545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Our prior magnetoencephalographic (MEG) investigations demonstrate that persons with cerebral palsy (CP) have weaker somatosensory cortical activity than neurotypical (NT) controls, which is associated with reduced muscular strength and mobility. Power training can improve lower extremity isokinetic strength, muscular power, and walking performance of youth with CP. Potentially, these clinically relevant improvements are partially driven by changes in somatosensory processing. The objective of this investigation was to determine if power training has complementary changes in muscular function and somatosensory cortical activity in youth with CP. METHODS A cohort of youth with CP (N = 11; age = 15.90 ± 1.1 years) and NT controls (N = 10; Age = 15.93 ± 2.48 years) participated in this investigation. Youth with CP underwent 24 power training sessions. Pre-post bilateral leg press 1-repetition maximum (1RM), peak power production, 10-m walking speed, and distance walked 1-min were used as outcome measures. MEG neuroimaging assessed the changes in somatosensory cortical activity while at rest. NT controls only underwent a baseline MEG assessment. RESULTS Youth with CP had a 56% increase in 1RM (p < 0.001), a 33% increase in peak power production (p = 0.019), and a 4% improvement in 1-min walk (p = 0.029). Notably, there was a 46% increase in somatosensory cortical activity (p = 0.02). INTERPRETATION These results are the first to show that power training is associated with improvements in muscular function, walking performance, and the resting somatosensory cortical activity in individuals with CP. This treatment approach might be advantageous due to the potential to promote cortical and muscular plasticity, which appear to have carryover effects for improved walking performance.
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Affiliation(s)
- Hannah Bergwell
- Institute for Human NeuroscienceBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Mike Trevarrow
- Institute for Human NeuroscienceBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Brad Corr
- Institute for Human NeuroscienceBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Sarah Baker
- Institute for Human NeuroscienceBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Heidi Reelfs
- Department of Physical Therapy, Munroe‐Meyer InstituteUniversity of Nebraska Medical CenterOmahaNebraskaUSA
| | - Tony W. Wilson
- Institute for Human NeuroscienceBoys Town National Research HospitalBoys TownNebraskaUSA
- Department of Pharmacology and Neuroscience, School of MedicineCreighton UniversityOmahaNebraskaUSA
| | - Noelle G. Moreau
- Department of Physical Therapy, School of Allied Health ProfessionsLouisiana State UniversityNew OrleansLouisianaUSA
| | - Max J. Kurz
- Institute for Human NeuroscienceBoys Town National Research HospitalBoys TownNebraskaUSA
- Department of Pharmacology and Neuroscience, School of MedicineCreighton UniversityOmahaNebraskaUSA
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Trevarrow MP, Reelfs A, Ott LR, Penhale SH, Lew BJ, Goeller J, Wilson TW, Kurz MJ. Altered spontaneous cortical activity predicts pain perception in individuals with cerebral palsy. Brain Commun 2022; 4:fcac087. [PMID: 35441137 PMCID: PMC9014448 DOI: 10.1093/braincomms/fcac087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/13/2022] [Accepted: 03/31/2022] [Indexed: 12/04/2022] Open
Abstract
Cerebral palsy is the most common paediatric neurological disorder and results in extensive impairment to the sensorimotor system. However, these individuals also experience increased pain perception, resulting in decreased quality of life. In the present study, we utilized magnetoencephalographic brain imaging to examine whether alterations in spontaneous neural activity predict the level of pain experienced in a cohort of 38 individuals with spastic diplegic cerebral palsy and 67 neurotypical controls. Participants completed 5 min of an eyes closed resting-state paradigm while undergoing a magnetoencephalography recording. The magnetoencephalographic data were then source imaged, and the power within the delta (2–4 Hz), theta (5–7 Hz), alpha (8–12 Hz), beta (15–29 Hz), low gamma (30–59 Hz) and high gamma (60–90 Hz) frequency bands were computed. The resulting power spectral density maps were analysed vertex-wise to identify differences in spontaneous activity between groups. Our findings indicated that spontaneous cortical activity was altered in the participants with cerebral palsy in the delta, alpha, beta, low gamma and high gamma bands across the occipital, frontal and secondary somatosensory cortical areas (all pFWE < 0.05). Furthermore, we also found that the altered beta band spontaneous activity in the secondary somatosensory cortices predicted heightened pain perception in the individuals with cerebral palsy (P = 0.039). Overall, these results demonstrate that spontaneous cortical activity within individuals with cerebral palsy is altered in comparison to their neurotypical peers and may predict increased pain perception in this patient population. Potentially, changes in spontaneous resting-state activity may be utilized to measure the effectiveness of current treatment approaches that are directed at reducing the pain experienced by individuals with cerebral palsy.
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Affiliation(s)
- Michael P. Trevarrow
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
| | - Anna Reelfs
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
| | - Lauren R. Ott
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
| | - Samantha H. Penhale
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
| | - Brandon J. Lew
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
| | - Jessica Goeller
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
| | - Max J. Kurz
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
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Trevarrow MP, Reelfs A, Baker SE, Hoffman RM, Wilson TW, Kurz MJ. Spinal cord microstructural changes are connected with the aberrant sensorimotor cortical oscillatory activity in adults with cerebral palsy. Sci Rep 2022; 12:4807. [PMID: 35314729 PMCID: PMC8938462 DOI: 10.1038/s41598-022-08741-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/21/2022] [Indexed: 11/20/2022] Open
Abstract
Previous animal models have illustrated that reduced cortical activity in the developing brain has cascading activity-dependent effects on the microstructural organization of the spinal cord. A limited number of studies have attempted to translate these findings to humans with cerebral palsy (CP). Essentially, the aberrations in sensorimotor cortical activity in those with CP could have an adverse effect on the spinal cord microstructure. To investigate this knowledge gap, we utilized magnetoencephalographic (MEG) brain imaging to quantify motor-related oscillatory activity in fourteen adults with CP and sixteen neurotypical (NT) controls. A subset of these participants also underwent cervical-thoracic spinal cord MRI. Our results showed that the strength of the peri-movement beta desynchronization and the post-movement beta rebound were each weaker in the adults with CP relative to the controls, and these weakened responses were associated with poorer task performance. Additionally, our results showed that the strength of the peri-movement beta response was associated with the total cross-sectional area of the spinal cord and the white matter cross-sectional area. Altogether these results suggest that the altered sensorimotor cortical activity seen in CP may result in activity-dependent plastic changes within the spinal cord microstructure, which could ultimately contribute to the sensorimotor deficits seen in this population.
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Affiliation(s)
- Michael P Trevarrow
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Boys Town, NE, 68010, USA
| | - Anna Reelfs
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Boys Town, NE, 68010, USA
| | - Sarah E Baker
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Boys Town, NE, 68010, USA
| | | | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Boys Town, NE, 68010, USA
| | - Max J Kurz
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Boys Town, NE, 68010, USA.
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Stronger proprioceptive BOLD-responses in the somatosensory cortices reflect worse sensorimotor function in adolescents with and without cerebral palsy. Neuroimage Clin 2022; 32:102795. [PMID: 34474316 PMCID: PMC8411230 DOI: 10.1016/j.nicl.2021.102795] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/18/2022]
Abstract
Cerebral palsy (CP) is a motor disorder where the motor defects are partly due to impaired proprioception. We studied cortical proprioceptive responses and sensorimotor performance in adolescents with CP and their typically-developed (TD) peers. Passive joint movements were used to stimulate proprioceptors during functional magnetic resonance imaging (fMRI) session to quantify the proprioceptive responses whose associations to behavioral sensorimotor performance were also examined. Twenty-three TD (15 females, age: mean ± standard deviation 14.2 ± 2.4 years) and 18 CP (12 females, age: mean ± standard deviation, 13.8 ± 2.3 years; 12 hemiplegic, 6 diplegic) participants were included in this study. Participants' index fingers and ankles were separately stimulated at 3 Hz and 1 Hz respectively with pneumatic movement actuators. Regions-of-interest were used to quantify BOLD-responses from the primary sensorimotor (SM1) and secondary (SII) somatosensory cortices and were compared across the groups. Associations between responses strengths and sensorimotor performance measures were also examined. Proprioceptive responses were stronger for the individuals with CP compared to their TD peers in SM1 (p < 0.001) and SII (p < 0.05) cortices contralateral to their more affected index finger. The ankle responses yielded no significant differences between the groups. The CP group had worse sensorimotor performance for hands and feet (p < 0.001). Stronger responses to finger stimulation in the dominant SM1 (p < 0.001) and both dominant and non-dominant SII (p < 0.01, p < 0.001) cortices were associated with the worse hand sensorimotor performance across all participants. Worse hand function was associated with stronger cortical activation to the proprioceptive stimulation. This association was evident both in adolescents with CP and their typically-developed controls, thus it likely reflects both clinical factors and normal variation in the sensorimotor function. The specific mechanisms need to be clarified in future studies.
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Ulloa JL. The Control of Movements via Motor Gamma Oscillations. Front Hum Neurosci 2022; 15:787157. [PMID: 35111006 PMCID: PMC8802912 DOI: 10.3389/fnhum.2021.787157] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/22/2021] [Indexed: 01/07/2023] Open
Abstract
The ability to perform movements is vital for our daily life. Our actions are embedded in a complex environment where we need to deal efficiently in the face of unforeseen events. Neural oscillations play an important role in basic sensorimotor processes related to the execution and preparation of movements. In this review, I will describe the state of the art regarding the role of motor gamma oscillations in the control of movements. Experimental evidence from electrophysiological studies has shown that motor gamma oscillations accomplish a range of functions in motor control beyond merely signaling the execution of movements. However, these additional aspects associated with motor gamma oscillation remain to be fully clarified. Future work on different spatial, temporal and spectral scales is required to further understand the implications of gamma oscillations in motor control.
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Affiliation(s)
- José Luis Ulloa
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
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Jobst C, D'Souza SJ, Causton N, Master S, Switzer L, Cheyne D, Fehlings D. Somatosensory Plasticity in Hemiplegic Cerebral Palsy Following Constraint Induced Movement Therapy. Pediatr Neurol 2022; 126:80-88. [PMID: 34742103 DOI: 10.1016/j.pediatrneurol.2021.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/16/2021] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Children with hemiplegic cerebral palsy (HCP) experience upper limb somatosensory and motor deficits. Although constraint-induced movement therapy (CIMT) improves motor function, its impact on somatosensory function remains underinvestigated. OBJECTIVE The objective of this study was to evaluate somatosensory perception and related brain responses in children with HCP, before and after a somatosensory enhanced CIMT protocol, as measured using clinical sensory and motor assessments and magnetoencephalography. METHODS Children with HCP attended a somatosensory enhanced CIMT camp. Clinical somatosensory (tactile registration, 2-point discrimination, stereognosis, proprioception, kinesthesia) and motor outcomes (Quality of Upper Extremity Skills [QUEST] Total/Grasp, Jebsen-Taylor Hand Function Test, grip strength, Assisting Hand Assessment), as well as latency and amplitude of magnetoencephalography somatosensory evoked fields (SEF), were assessed before and after the CIMT camp with paired sample t-tests or Wilcoxon signed-rank tests. RESULTS Twelve children with HCP (mean age: 7.5 years, standard deviation: 2.4) participated. Significant improvements in tactile registration for the affected (hemiplegic) hand (Z = 2.39, P = 0.02) were observed in addition to statistically and clinically significant improvements in QUEST total (t = 3.24, P = 0.007), QUEST grasp (t = 3.24, P = 0.007), Assisting Hand Assessment (Z = 2.25, P = 0.03), and Jebsen-Taylor Hand Function Test (t = -2.62, P = 0.03). A significant increase in the SEF peak amplitude was also found in the affected hand 100 ms after stimulus onset (t = -2.22, P = 0.04). CONCLUSIONS Improvements in somatosensory clinical function and neural processing in the affected primary somatosensory cortex in children with HCP were observed after a somatosensory enhanced CIMT program. Further investigation is warranted to continue to evaluate the effectiveness of a sensory enhanced CIMT program in larger samples and controlled study designs.
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Affiliation(s)
- Cecilia Jobst
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Samantha J D'Souza
- Rehabilitation Science Institute, University of Toronto, Toronto, Ontario, Canada; Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Natasha Causton
- Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Sabah Master
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lauren Switzer
- Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Douglas Cheyne
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Darcy Fehlings
- Rehabilitation Science Institute, University of Toronto, Toronto, Ontario, Canada; Holland Bloorview Kids Rehabilitation Hospital, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
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Brun C, Traverse É, Granger É, Mercier C. Somatosensory deficits and neural correlates in cerebral palsy: a scoping review. Dev Med Child Neurol 2021; 63:1382-1393. [PMID: 34145582 PMCID: PMC9290873 DOI: 10.1111/dmcn.14963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 12/15/2022]
Abstract
AIM To synthetize studies assessing somatosensory deficits and alterations in cerebral responses evoked by somatosensory stimulation in individuals with cerebral palsy (CP) compared to typically developing individuals. METHOD A scoping review of the literature was performed in the MEDLINE, Embase, PsycInfo, CINAHL, Evidence-Based Medicine Reviews, and Web of Science databases (last search carried out on 6th and 7th August 2020) with a combination of keywords related to CP and somatosensory functions. Somatosensory deficits were measured with clinical tests and alterations in cerebral responses were measured with functional magnetic resonance imaging, electroencephalography, and magnetoencephalography. RESULTS Forty-eight articles were included. Overall, 1463 participants with CP (mean [SD] age 13y 1mo [4y 11mo], range 1-55y; 416 males, 319 females, sex not identified for the remaining participants) and 1478 controls (mean [SD] age 13y 1mo [5y 8mo], range 1-42y; 362 males, 334 females, sex not identified for the remaining participants) were included in the scoping review. For tactile function, most studies reported registration (8 out of 13) or perception (21 out of 21) deficits in participants with CP. For proprioception, most studies also reported registration (6 out of 8) or perception (10 out of 15) deficits. Pain function has not been studied as much, but most studies reported registration (2 out of 3) or perception (3 out of 3) alterations. Neuroimaging findings (18 studies) showed alterations in the somatotopy, morphology, latency, or amplitude of cortical responses evoked by somatosensory stimuli. INTERPRETATION Despite the heterogeneity in the methods employed, most studies reported somatosensory deficits. The focus has been mainly on tactile and proprioceptive function, whereas pain has received little attention. Future research should rigorously define the methods employed and include a sample that is more representative of the population with CP. What this paper adds Most of the papers reviewed found tactile registration and perception deficits in the upper limbs. Proprioceptive deficits were generally observed in cerebral palsy but results were heterogeneous. Pain has received little attention compared to tactile and proprioceptive functions. Neuroimaging studies supported behavioral observations. Alterations were observed for both the most and least affected limb.
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Affiliation(s)
- Clémentine Brun
- Center for Interdisciplinary Research in Rehabilitation and Social IntegrationQuebec CityQuebecCanada
| | - Élodie Traverse
- Center for Interdisciplinary Research in Rehabilitation and Social IntegrationQuebec CityQuebecCanada,Department of RehabilitationLaval UniversityQuebec CityQuebecCanada
| | - Élyse Granger
- Centre IntégréUniversitaire de Santé et de Services Sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social IntegrationQuebec CityQuebecCanada,Department of RehabilitationLaval UniversityQuebec CityQuebecCanada
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Trevarrow MP, Kleinsmith J, Taylor BK, Wilson TW, Kurz MJ. The somatosensory cortical activity in individuals with cerebral palsy displays an aberrant developmental trajectory. J Physiol 2020; 599:1281-1289. [PMID: 33296078 DOI: 10.1113/jp280400] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/16/2020] [Indexed: 12/31/2022] Open
Abstract
KEY POINTS Individuals with cerebral palsy (CP) have a reduced somatosensory cortical response Somatosensory cortical response strength decreases from adolescence to early adulthood Somatosensory cortical responses in youth with CP are similar to adult controls Individuals with CP may have aberrant maturation of the somatosensory system ABSTRACT: Numerous studies have documented tactile and proprioceptive deficits in children with cerebral palsy (CP) and linked these with weaker somatosensory cortical activity. However, whether such aberrations in somatosensory processing extend and/or progress into adulthood remains poorly understood. In the current study, we used magnetoencephalography (MEG) to investigate the primary somatosensory responses in a sample of individuals with CP (N = 42; age = 9-28 years) and a cohort of healthy controls (N = 23; age range = 11-23 years). Briefly, transient electrical stimulation was applied to the right tibial nerve, and standardized low-resolution brain electromagnetic tomography (sLORETA) was used to image the dynamic somatosensory cortical response. We found that the strength of somatosensory cortical activity within the 112-252 ms time window was significantly reduced in the individuals with CP compared with the healthy controls (HC = 286.53 ± 30.51, 95% CI [226.74, 346.32]; CP = 208.30 ± 19.66,CI [169.77, 246.83], P = 0.0126). These results corroborate previous findings of aberrant somatosensory cortical activity in individuals with CP. Our results also suggest that the somatosensory cortical activity tends to become weaker with age, with a similar rate of neurophysiological change in individuals with CP and healthy controls (P = 0.8790). Visualization of regression models fitted to the data imply that youth with CP may have somatosensory cortical activity similar to adult controls. These findings suggest that some individuals with CP exhibit an aberrant developmental trajectory of their somatosensory system.
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Affiliation(s)
- Michael P Trevarrow
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | | | - Brittany K Taylor
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Max J Kurz
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
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Hoffman RM, Wilson TW, Kurz MJ. Hand Motor Actions of Children With Cerebral Palsy Are Associated With Abnormal Sensorimotor Cortical Oscillations. Neurorehabil Neural Repair 2019; 33:1018-1028. [PMID: 31679451 DOI: 10.1177/1545968319883880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background. The neuroimaging literature on cerebral palsy (CP) has predominantly focused on identifying the structural aberrations (eg, fiber track integrity), with very few studies examining neural activity within the key networks that serve the production of hand movements. Objective. We aimed to start to fill this knowledge gap by using magnetoencephalographic brain imaging to quantify the temporal dynamics of the sensorimotor oscillations during a hand motor action. Methods: Children with CP (n = 12; MACS [Manual Abilities Classification System] levels I-III) and typically developing (TD) children (n = 26) performed an arrow-based version of the Eriksen flanker task where a button press was performed with either the second or third digit of the right hand depending on the arrow's direction. Results: Overall, the children with CP were less accurate and had slower reaction times compared with the TD children. These behavioral differences were closely linked with aberrant sensorimotor cortical oscillations seen in the children with CP. Compared with the TD children, the children with CP had a weaker gamma (68-82 Hz) response during motor execution and a weaker post-movement beta rebound (PMBR; 14-26 Hz) response on movement termination. Moreover, we observed a significant correlation between the amplitude of the gamma and PMBR with reaction time, with weaker gamma and PMBR responses being linked with slower reaction times. Conclusions: Overall, these results suggest that aberrations in motor-related gamma and beta cortical oscillations are associated with the impaired hand motor actions seen in children with CP.
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Affiliation(s)
| | - Tony W Wilson
- University of Nebraska Medical Center, Omaha, NE, USA
| | - Max J Kurz
- University of Nebraska Medical Center, Omaha, NE, USA
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14
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Kurz MJ, Wiesman AI, Coolidge NM, Wilson TW. Children with Cerebral Palsy Hyper-Gate Somatosensory Stimulations of the Foot. Cereb Cortex 2019; 28:2431-2438. [PMID: 28591842 DOI: 10.1093/cercor/bhx144] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Indexed: 12/15/2022] Open
Abstract
We currently have a substantial knowledge gap in our understanding of the neurophysiological underpinnings of the sensory perception deficits often reported in the clinic for children with cerebral palsy (CP). In this investigation, we have begun to address this knowledge gap by using magnetoencephalography (MEG) brain imaging to evaluate the sensory gating of neural oscillations in the somatosensory cortices. A cohort of children with CP (Gross Motor Function Classification System II-III) and typically developing children underwent paired-pulse electrical stimulation of the tibial nerve during MEG. Advanced beamforming methods were used to image significant oscillatory responses, and subsequently the time series of neural activity was extracted from peak voxels. Our experimental results showed that somatosensory cortical oscillations (10-75 Hz) were weaker in the children with CP for both stimulations. Despite this reduction, the children with CP actually exhibited a hyper-gating response to the second, redundant peripheral stimulation applied to the foot. These results have further established the nexus of the cortical somatosensory processing deficits that are likely responsible for the degraded sensory perceptions reported in the clinic for children with CP.
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Affiliation(s)
- Max J Kurz
- Department of Physical Therapy, Munroe Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA.,Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA
| | - Alex I Wiesman
- Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA.,Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Nathan M Coolidge
- Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tony W Wilson
- Center for Magnetoencephalography, University of Nebraska Medical Center, Omaha, NE, USA.,Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
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15
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Démas J, Bourguignon M, Périvier M, De Tiège X, Dinomais M, Van Bogaert P. Mu rhythm: State of the art with special focus on cerebral palsy. Ann Phys Rehabil Med 2019; 63:439-446. [PMID: 31299375 DOI: 10.1016/j.rehab.2019.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/16/2019] [Accepted: 06/10/2019] [Indexed: 01/24/2023]
Abstract
Various specific early rehabilitation strategies are proposed to decrease functional disabilities in patients with cerebral palsy (CP). These strategies are thought to favour the mechanisms of brain plasticity that take place after brain injury. However, the level of evidence is low. Markers of brain plasticity would favour validation of these rehabilitation programs. In this paper, we consider the study of mu rhythm for this goal by describing the characteristics of mu rhythm in adults and children with typical development, then review the current literature on mu rhythm in CP. Mu rhythm is composed of brain oscillations recorded by electroencephalography (EEG) or magnetoencephalography (MEG) over the sensorimotor areas. The oscillations are characterized by their frequency, topography and modulation. Frequency ranges within the alpha band (∼10Hz, mu alpha) or beta band (∼20Hz, mu beta). Source location analyses suggest that mu alpha reflects somatosensory functions, whereas mu beta reflects motor functions. Event-related desynchronisation (ERD) followed by event-related (re-)synchronisation (ERS) of mu rhythm occur in association with a movement or somatosensory input. Even if the functional role of the different mu rhythm components remains incompletely understood, their maturational trajectory is well described. Increasing age from infancy to adolescence is associated with increasing ERD as well as increasing ERS. A few studies characterised mu rhythm in adolescents with spastic CP and showed atypical patterns of modulation in most of them. The most frequent findings in patients with unilateral CP are decreased ERD and decreased ERS over the central electrodes, but atypical topography may also be found. The patterns of modulations are more variable in bilateral CP. Data in infants and young children with CP are lacking and studies did not address the questions of intra-individual reliability of mu rhythm modulations in patients with CP nor their modification after motor learning. Better characterization of mu rhythm in CP, especially in infants and young children, is warranted before considering this rhythm as a potential neurophysiological marker of brain plasticity.
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Affiliation(s)
- Josselin Démas
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS), Université d'Angers, France; Institut Régional de Formation aux Métiers de Rééducation et de Réadaptation (IFM3R), Nantes, France.
| | - Mathieu Bourguignon
- Laboratoire de Cartographie Fonctionnelle du Cerveau (LCFC), UNI-ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratoire Cognition Language et Développement, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), Brussels, Belgium; Department of functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Maximilien Périvier
- Service de Neuropédiatrie et handicaps de l'enfant, Hôpital pédiatrique Gatien de Clocheville, CHRU de Tours, France; Université de Tours, France
| | - Xavier De Tiège
- Laboratoire de Cartographie Fonctionnelle du Cerveau (LCFC), UNI-ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium; Department of functional Neuroimaging, Service of Nuclear Medicine, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Mickael Dinomais
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS), Université d'Angers, France; Département de Médecine Physique et de Réadaptation, CHU d'Angers-Les Capucins, France
| | - Patrick Van Bogaert
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS), Université d'Angers, France; Unité de Neuropédiatrie et de Neurochirurgie de l'enfant, CHU d'Angers, France
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Papadelis C, Butler EE, Rubenstein M, Sun L, Zollei L, Nimec D, Snyder B, Grant PE. Reorganization of the somatosensory cortex in hemiplegic cerebral palsy associated with impaired sensory tracts. Neuroimage Clin 2017; 17:198-212. [PMID: 29159037 PMCID: PMC5683344 DOI: 10.1016/j.nicl.2017.10.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/27/2017] [Accepted: 10/18/2017] [Indexed: 02/08/2023]
Abstract
Functional neuroimaging studies argue that sensory deficits in hemiplegic cerebral palsy (HCP) are related to deviant somatosensory processing in the ipsilesional primary somatosensory cortex (S1). A separate body of structural neuroimaging literature argues that these deficits are due to structural damage of the ascending sensory tracts (AST). The relationship between the functional and structural integrity of the somatosensory system and the sensory performance is largely unknown in HCP. To address this relationship, we combined findings from magnetoencephalography (MEG) and probabilistic diffusion tractography (PDT) in 10 children with HCP and 13 typically developing (TD) children. With MEG, we mapped the functionally active regions in the contralateral S1 during tactile stimulation of the thumb, middle, and little fingers of both hands. Using these MEG-defined functional active regions as regions of interest for PDT, we estimated the diffusion parameters of the AST. Somatosensory function was assessed via two-point discrimination tests. Our MEG data showed: (i) an abnormal somatotopic organization in all children with HCP in either one or both of their hemispheres; (ii) longer Euclidean distances between the digit maps in the S1 of children with HCP compared to TD children; (iii) suppressed gamma responses at early latencies for both hemispheres of children with HCP; and (iv) a positive correlation between the Euclidean distances and the sensory tests for the more affected hemisphere of children with HCP. Our MEG-guided PDT data showed: (i) higher mean and radian diffusivity of the AST in children with HCP; (ii) a positive correlation between the axial diffusivity of the AST with the sensory tests for the more affected hemisphere; and (iii) a negative correlation between the gamma power change and the AD of the AST for the MA hemisphere. Our findings associate for the first time bilateral cortical functional reorganization in the S1 of HCP children with abnormalities in the structural integrity of the AST, and correlate these abnormalities with behaviorally-assessed sensory deficits.
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Affiliation(s)
- Christos Papadelis
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Erin E Butler
- Thayer School of Engineering, Dartmouth College, Hanover, NH, USA; William H. Neukom Institute for Computational Science, Dartmouth College, Hanover, NH, USA
| | - Madelyn Rubenstein
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Limin Sun
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lilla Zollei
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Donna Nimec
- Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Brian Snyder
- Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Patricia Ellen Grant
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Papadelis C, Ahtam B, Nazarova M, Nimec D, Snyder B, Grant PE, Okada Y. Cortical somatosensory reorganization in children with spastic cerebral palsy: a multimodal neuroimaging study. Front Hum Neurosci 2014; 8:725. [PMID: 25309398 PMCID: PMC4162364 DOI: 10.3389/fnhum.2014.00725] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/28/2014] [Indexed: 12/17/2022] Open
Abstract
Although cerebral palsy (CP) is among the most common causes of physical disability in early childhood, we know little about the functional and structural changes of this disorder in the developing brain. Here, we investigated with three different neuroimaging modalities [magnetoencephalography (MEG), diffusion tensor imaging (DTI), and resting-state fMRI] whether spastic CP is associated with functional and anatomical abnormalities in the sensorimotor network. Ten children participated in the study: four with diplegic CP (DCP), three with hemiplegic CP (HCP), and three typically developing (TD) children. Somatosensory (SS)-evoked fields (SEFs) were recorded in response to pneumatic stimuli applied to digits D1, D3, and D5 of both hands. Several parameters of water diffusion were calculated from DTI between the thalamus and the pre-central and post-central gyri in both hemispheres. The sensorimotor resting-state networks (RSNs) were examined by using an independent component analysis method. Tactile stimulation of the fingers elicited the first prominent cortical response at ~50 ms, in all except one child, localized over the primary SS cortex (S1). In five CP children, abnormal somatotopic organization was observed in the affected (or more affected) hemisphere. Euclidean distances were markedly different between the two hemispheres in the HCP children, and between DCP and TD children for both hemispheres. DTI analysis revealed decreased fractional anisotropy and increased apparent diffusion coefficient for the thalamocortical pathways in the more affected compared to less affected hemisphere in CP children. Resting-state functional MRI results indicated absent and/or abnormal sensorimotor RSNs for children with HCP and DCP consistent with the severity and location of their lesions. Our findings suggest an abnormal SS processing mechanism in the sensorimotor network of children with CP possibly as a result of diminished thalamocortical projections.
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Affiliation(s)
- Christos Papadelis
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA
| | - Banu Ahtam
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA
| | - Maria Nazarova
- Department of Neurorehabilitation and Physiotherapy, Research Center of Neurology , Moscow , Russia ; Centre for Cognition and Decision Making, Faculty of Psychology, Higher School of Economics , Moscow , Russia
| | - Donna Nimec
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA
| | - Brian Snyder
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA
| | - Patricia Ellen Grant
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Department of Radiology, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA
| | - Yoshio Okada
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA ; Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston, MA , USA
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Pihko E, Nevalainen P, Vaalto S, Laaksonen K, Mäenpää H, Valanne L, Lauronen L. Reactivity of sensorimotor oscillations is altered in children with hemiplegic cerebral palsy: A magnetoencephalographic study. Hum Brain Mapp 2014; 35:4105-17. [PMID: 24522997 DOI: 10.1002/hbm.22462] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 12/20/2013] [Accepted: 01/03/2014] [Indexed: 11/05/2022] Open
Abstract
Cerebral palsy (CP) is characterized by difficulty in control of movement and posture due to brain damage during early development. In addition, tactile discrimination deficits are prevalent in CP. To study the function of somatosensory and motor systems in CP, we compared the reactivity of sensorimotor cortical oscillations to median nerve stimulation in 12 hemiplegic CP children vs. 12 typically developing children using magnetoencephalography. We also determined the primary cortical somatosensory and motor representation areas of the affected hand in the CP children using somatosensory-evoked magnetic fields and navigated transcranial magnetic stimulation, respectively. We hypothesized that the reactivity of the sensorimotor oscillations in alpha (10 Hz) and beta (20 Hz) bands would be altered in CP and that the beta-band reactivity would depend on the individual pattern of motor representation. Accordingly, in children with CP, suppression and rebound of both oscillations after stimulation of the contralateral hand were smaller in the lesioned than intact hemisphere. Furthermore, in two of the three children with CP having ipsilateral motor representation, the beta- but not alpha-band modulations were absent in both hemispheres after affected hand stimulation suggesting abnormal sensorimotor network interactions in these individuals. The results are consistent with widespread alterations in information processing in the sensorimotor system and complement current understanding of sensorimotor network development after early brain insults. Precise knowledge of the functional sensorimotor network organization may be useful in tailoring individual rehabilitation for people with CP.
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Affiliation(s)
- Elina Pihko
- Brain Research Unit, O.V. Lounasmaa Laboratory, Aalto University School of Science, Espoo, Finland
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Sajedi F, Ahmadlou M, Vameghi R, Gharib M, Hemmati S. Linear and nonlinear analysis of brain dynamics in children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1388-1396. [PMID: 23474991 DOI: 10.1016/j.ridd.2013.01.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 01/20/2013] [Accepted: 01/21/2013] [Indexed: 06/01/2023]
Abstract
This study was carried out to determine linear and nonlinear changes of brain dynamics and their relationships with the motor dysfunctions in CP children. For this purpose power of EEG frequency bands (as a linear analysis) and EEG fractality (as a nonlinear analysis) were computed in eyes-closed resting state and statistically compared between 26 CP and 26 normal children. Based on these characteristics accuracy of the classification between the two groups was obtained by enhanced probabilistic neural network (EPNN). Severity of gross motor and manual disabilities was determined by standard systems and the relation between the deficient brain dynamics and severity of the motor dysfunctions was obtained by Pearson's correlation coefficient. A definitely higher delta and lower theta and alpha powers, and higher EEG complexity in CP patients. As such a high accuracy of 94.8% in distinguishing the two groups was obtained. Moreover significant positive correlations were found between beta power and severity of manual disabilities and gross motor dysfunctions in the boys with CP. It is concluded that the obtained brain dynamics' characteristics are useful in diagnosis of CP. Furthermore severity of the motor dysfunctions in boys with CP could be evaluated by the beta activity.
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Affiliation(s)
- Firoozeh Sajedi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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